Individual provider Active NPI

Nayara Inocencio de Souza, MSW, LCSW

  • Clinical Social Worker
  • Lynn, MA
National Provider Identifier
1235656141
Registry record updated Aug 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
222882 Issued in MA
Practice address
95 Pleasant St
Lynn, MA 01901-1524
Phone
(781) 581-4400
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 222882 MA Primary

Addresses

Primary practice location

95 Pleasant St
Lynn, MA 01901-1524

Mailing address

84 School St
Charlestown, MA 02129-2409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220628002977 MA Practitioner - Clinical Social Worker 4981083565 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
222882MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Eliot Community Human Services Current Accepting new patients
Eliot Community Human Services CurrentSince Mar 10, 2022 Accepting new patients

Locations

173 Chelsea St
Everett, MA 02149
Phone (617) 397-2020

125 Hartwell Ave
Lexington, MA 02421
Phone (781) 734-2060

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1235656141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 SCHOOL ST",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021292409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 PLEASANT ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011524",
            "telephone_number": "781-581-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "NAYARA",
        "middle_name": "INOCENCIO DE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "222882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.